POS1191-HPR ULTRASONOGRAPHIC AND FUNCTIONAL CORRELATION OF THE FEET IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: L. Cano Garcia, J. García-Campos, F. Ortiz-Márquez, A. Reinoso Cobo, L. Ramos Petersen, J. Marco-Lledó
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Systemic lupus erythematosus (SLE) is a chronic immune-mediated disease with involvement of various organs<sup>[1,2]</sup>. El 95% of patients with SLE have musculoskeletal involvement<sup>[1]</sup>, most often in the form of arthralgias or non-erosive arthritis affecting mostly the hands and knees. A subgroup of patients with SLE, which is seen with increasing frequency, late develops a deforming arthropathy as a result of laxity of ligaments and peritendinous apparatus resulting in joint subluxations and tendon ruptures which is part of the accumulated damage of the disease. The foot is a heavily affected structure that may initially go unnoticed, but results in significant disability. <h3>Objectives</h3> To determine the relationship between inflammatory activity measured by ultrasound in metatarsophalangeal (MTF) and questionnaires of foot functionality, hand deformities and SLE activity. <h3>Methods</h3> A cross-sectional study was performed. Thirty-six subjects with a diagnosis of SLE in the Rheumatology Unit were consecutively recruited between March and June 2022. Inclusion criteria were: patients with SLE diagnosis according to EULAR/ACR 2019 criteria, with at least one year of evolution and age equal or older than 18 years. A Rheumatology nurse collected information on socio-demographic data, questionnaires and ultrasound scans. The SLE activity questionnaires completed were: SLEDAI and SLICC, quality of life: EQ-5D, foot function: FFI (Foot Function Index), FAAM (Foot and Ankle Ability Measures Questionnaire), FPI (Foot Posture Index). As for hand malformations collected were: Jaccoud arthropathy, non-reducible arthritis, z-finger, grommet finger, non-reducible arthritis, burst finger and gooseneck finger. A descriptive, bivariate and R-Pearson correlation analysis was performed. <h3>Results</h3> Thirty-six SLE patients (97.2% female) with a mean (SD) age of 49.31 (11.4) years with a range 23-66 years participated. A total of 30 patients (83.3%) showed at least one MTF synovitis, the most frequent being 2nd MTF left (58.8%) and right (44.4%), followed by 1st MTF right and left (41.7%). The number of patients with and without ultrasound synovitis, as well as the degree of synovitis and Doppler signal in each joint are shown in Table 1. A significant direct correlation was observed between inflammatory activity with Doppler in the 1st MTF of the right foot with the SLICC (r=0.439; p=0.007) and SLEDAI (r=0.608; p&lt;0.001) questionnaire; as well as an inverse relationship between synovitis in the 1st toe of the right foot with the FPI questionnaire of the right foot (r=-0.340; p=0.040) (Table 2). Likewise, a significant relationship was observed between deformity in the hands with the synovitis of 5 right (p=0.042) and left (p=0.005) MTFs. <h3>Conclusion</h3> Ultrasound synovitis in MTFs is common in SLE patients and is associated with disease activity, some deformities and functionality. <h3>References</h3> [1] Cherry L, Alcacer-Pitarch B, Hopkinson N, Teh LS, Vital EM, Edwards CJ, et al. The prevalence of self-reported lower limb and foot health problems experienced by participants with systemic lupus erythematosus: Results of a UK national survey. Lupus. 2017 Apr;26(4):410-416. [2] Durcan L, O'Dwyer T, Petri M. Management strategies and future directions for systemic lupus erythematosus in adults. Lancet. 2019 Jun 8;393(10188):2332-2343. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.